The Time I Saved the World

That was the time that I saved the world. Well, not really.

But that was the attitude of my youth. I have had to learn and grow from those days.

The year was 1993.  I was 2 years out of my internship and fresh from my flight surgery training in the U.S. Navy. Suddenly I was the department head of the medical department for NAVAIRES Norfolk (Naval Air Reserve Center in Norfolk, VA). I was responsible for ensuring the medical fitness of several thousand reservists with the support of a chief petty officer plus about a dozen other corpsmen. Every other weekend we would use reserve physicians and do hundreds of physical examinations. We would obtain routine labs on everyone who had a physical. What bothered me was that there was no clear mechanism as to what to do with the abnormal lab results. There was a real risk that we would detect something serious and then fail to act. The current process was not as tight as I thought it should be. It also was very labor intensive and manual in nature.

I set about trying to optimize and automate the process. What I eventually came up with was a complex macro in WordPerfect to enter abnormal lab results and then generate letters and track the patient responses. I thought it was ingenious. When I finished it and explained it to my corpsmen however, I began to realize how complex it was to use. My next step was to prepare a guide for how to operationalize it. In the end I had a 3-ring binder with too many pages of instructions complete with backups of the macro on floppy disks.

It did work. But it was pretty dependent on me. I am not sure that it survived as soon as I left that job and someone else took over.

I learned a lot in those years in the Navy. I began to get a bit jaded when I would see someone come into a command and make changes and get an award for their work. Then the next person would come and change things back and also get an award for their work. It seemed like there was very little new “under the sun.” 

During that time the work of Edwards Deming and “Total Quality Leadership” or “TQL” was the newest craze for the Navy. It came from Japanese manufacturing efficiency and involved a lot of meetings with flow charts and was just the beginning of what has come to be a steady stream of process improvement techniques. Our commanding officer was very enthused about the possibilities. At the department head level he had us take on a sample project together. We spent the next 6 months meeting. We went through the steps including drawing up flow charts and process maps. We had lists of problems from the current state leading to potential solutions. We met 1-2x/week for 6 months plus an offsite 3-4 day session. In the end we adopted the process that had been recommended months earlier by the division head.

The new process worked very well, however. It was a success. The CO celebrated all of our work and the success of TQL as the “wave of the future” for how efficient and effective operations will be decided.

We had “saved the world” for all time! Or at least in regard to how reservists’ lodging was booked and planned in Norfolk, VA.

Personally, I am a process person. I can remember one physics homework assignment in college. Each problem involved a bunch of repeated complicated calculations. It seemed like busywork to me. I instead spent my time writing a computer program (in Fortran) to do the calculations for me. Once completed it did all of my homework in just a few minutes and did it flawlessly. I spent about the same or more amount of time writing the program as I would have to just do the math by hand. But I was much happier to fix the process than to just do the work.

Over time however I have started to question some of the assumptions that I would make when I was young about “fixing” processes. My WordPerfect macros were nice. But they were not really sustainable. In my youth I really thought I could permanently “fix the world”. What I have since come to realize is that no matter how perfectly groomed the garden may be, once you look away, weeds begin to grow. 

This world is not perfect. Order tends to disorder. Entropy is real and powerful. And no matter how well intentioned I may be, the issue often is not of one large and permanent fix. Rather it is about finding the people and empowering them to be able to push against the entropy.

I no longer look to permanently fix this world.

I still am a big person for process. We should not do stupid and excessive work. We should not try to continually push through a bad process. We should try to fix things. But we also should not so naively think that it is going to be possible to implement a one-time permanent fix for problems. They ARE going to come back. Weeds are going to grow. Sustainability is often far more important than the initial process improvement.

This has far more deep wisdom in it than I think I have been able to communicate so far. Bear with me as I try to explain more.

What is the most valuable use of our time? And how do we think about this world? Is the world like a computer where we can write perfect code and have it work flawlessly every single time it is used? Or is it a flawed world where every week brings another crisis or problem? 

The truth of the matter is that this is a beautiful but very flawed world. Each week does indeed bring a new crisis. If you think that you are going to fix all of the problems forever and permanently you are going to be sorely disappointed. You will find yourself getting frustrated and angry as each new problem pops up. It is as though you put your finger in a hole to plug a leak only to have two more pop up. 

I don’t mean to “rain on the parade” or decrease the value of the “Naval Commendation Medal” that I got for my time at NAVAIRES Norfolk. Humbly I will say that I did good work. But if I had to go back to my younger self I would have a few lessons for him:

1. Improving process is good but remember it is not everything.
2. Keeping things simpleis very important for sustainability. If you create a complex process it will be short lived and your work will be wasted.
3. People are often as important or even more important than process. Investing your time in growing and developing the skills in people is immensely valuable.That work will pay many dividends through years and years that go far beyond the process or problem that is in front of you.
4. It is ok to be optimistic and think that you can “save the world.” But it is wise to know that it is ok if you just improve things for a season. This is a flawed world. Weeds are going to grow. When you plug one hole in the old bag another will soon form and will need to be fixed. Do not tire of doing good. If you can improve the world for the time and place in which you are put you have done a good thing. You don’t necessarily have the save the entire world. It is enough to do good today, here, and now.